Specialist I, Prior Authorization-Lumicera

1 week ago

Madison, WI, United States Navitus Health Solutions Full time


Specialist I, Prior Authorization-Lumicera

Location

US-

ID

2025-4819

Category

Customer Service/Support

Position Type

Full-Time

Remote

Yes

Company

Lumicera

About Us

Lumicera - Lumicera Health Services Powered by Navitus - Innovative Specialty Pharmacy Solutions- Lumicera Health Services is defining the "new norm" in specialty pharmacy to optimize patient well-being through our core principles of transparency and stewardship. Here at Lumicera, our team members work in an environment that celebrates creativity and fosters diversity. .______________________________________________________________________________________________________________________________________________________________________________________________________. Current associates must use SSO login option at https://employees-navitus.icims.com/ to be considered for internal opportunities.

Pay Range

USD $18.67 - USD $21.96 /Hr.

STAR Bonus % (At Risk Maximum)

0.00 - Ineligible

Work Schedule Description (e.g. M-F 8am to 5pm)

M-F 8 hr shift in between

Remote Work Notification

ATTENTION: Lumicera is unable to offer remote work to residents of Alaska, Connecticut, Delaware, Hawaii, Kansas, Kentucky, Maine, Massachusetts, Mississippi, Montana, Nebraska, New Hampshire, New Mexico, North Dakota,Rhode Island, South Carolina, South Dakota, Vermont, West Virginia, and Wyoming.

Overview

Lumicera Health Services is seeking a Prior Authorization Specialist I to join our team

Under direction from the Supervisor, Specialty Pharmacy Services, and pharmacists in the Specialty Pharmacy, the Prior Authorization Specialist I is primarily responsible for obtaining information and assisting providers and insurance companies in triaging prior authorizations for patients of the specialty pharmacy. The Prior Authorization Specialist's main objective is to answer phone calls and contact the doctors and patients via fax or phone or other communication means to facilitate and document prior authorization approval. The Prior Authorization Specialist may also be responsible for ensuring that all pertinent patient information is contained within the record. Patient information shall include demographics, allergies, medication history, comorbidities, and payer information. This position will function with and assist any other area in the facility as needed with regard to prior authorization type duties.

Is this you? Find out more below

Responsibilities

How do I make an impact on my team?

  • Responsible for answering the inbound calls from patients, prescribers, and other healthcare professionals
  • Responsible for contacting doctors to obtain necessary information
  • Responsible for managing the assigned workflow queues
  • Responsible for accurate and thorough documentation of information and prescription order set up
  • The Employee will act in accordance with all applicable federal and state laws and with the highest ethical standards that we consistently strive to achieve. Thus, legal and ethical compliance is an essential duty of each employee
  • Other duties as assigned


Qualifications

What our team expects from you?

  • High school diploma or GED
  • Some college preferred
  • CPhT Preferred
  • Pharmacy technician license or pharmacy technician trainee license is strongly preferred in states requiring pharmacy technician licensure
  • Minimum two years pharmacy support experience or healthcare environment experience preferred
  • Ability to work scheduled hours, shifts may vary based on department needs. Hours of operation are 8am to 7pm Monday thru Thursday and 8am to 6pm on Friday
  • Participate in, adhere to, and support compliance program objectives
  • The ability to consistently interact cooperatively and respectfully with other employees

What can you expect from Navitus?

  • Top of the industry benefits for Health, Dental, and Vision insurance

  • 20 days paid time off

  • 4 weeks paid parental leave

  • 9 paid holidays

  • 401K company match of up to 5% - No vesting requirement

  • Adoption Assistance Program

  • Flexible Spending Account

  • Educational Assistance Plan and Professional Membership assistance

  • Referral Bonus Program - up to $750

#LI-Remote

Location : Address

Remote

Location : Country

US

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